| Greg Mattson Md Inc | |
|
210 Coast Blvd La Jolla CA 92037-4609 | |
| (858) 454-6141 | |
| (858) 454-2310 |
| Full Name | Greg Mattson Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 210 Coast Blvd, La Jolla, California |
| Authorized Official Name and Position | Gregory Capp Mattson (PRESIDENT) |
| Authorized Official Contact | 8584542716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greg Mattson Md Inc 210 Coast Blvd La Jolla CA 92037-4609 Ph: (858) 454-6141 | Greg Mattson Md Inc 210 Coast Blvd La Jolla CA 92037-4609 Ph: (858) 454-6141 |
| NPI Number | 1669746897 |
|---|---|
| Provider Enumeration Date | 03/06/2012 |
| Last Update Date | 03/06/2012 |
| Medicare PECOS PAC ID | 0345409066 |
|---|---|
| Medicare Enrollment ID | O20120315000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669746897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G32164 (California) | Primary |
| Provider Name | Gregory C Mattson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1922155282 PECOS PAC ID: 4880853506 Enrollment ID: I20120315000227 |
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